Aim. The sural nerve complex (SNC) consists of four named components: medial sural cutaneous nerve (MSCN), lateral sural cutaneous nerve (LSCN), peroneal communicating nerve (PCN), and sural nerve (SN). The formation and distribution of the sural nerve vary in different individuals. SN is universally recognized by surgeons as a site for harvesting an autologous nerve graft. The nerve is widely used for electrophysiological studies. Hence the study of sural nerve complex was taken up. Method. SNC was observed by dissecting 100 lower limbs in the department of anatomy at three different medical colleges, over a period of 10 years. Result. Typical SN was observed in 60% of the cases. MSCN was present in all the cases; in 15% of the cases the MSCN followed an intramural course. LSCN was present in 80% of the cases. PCN was present in 70% of the cases and in most of the cases calibre was larger than that of MSCN. Conclusion. The knowledge about the variation in the origin and course of the SN is important in evaluating sensory axonal loss in distal axonal neuropathies and should be borne in mind by clinicians and surgeons. 1. Introduction Sural nerve is one of the cutaneous nerves of the lower limb. It is a branch from tibial nerve (TN) in the popliteal fossa, descends between the two heads of the gastrocnemius muscle, and pierces the deep fascia in the middle third of the posterior surface of the leg. It is usually joined by the peroneal communicating nerve (sural communicating nerve) which is a branch of common peroneal nerve (CPN) [1, 2]. Many authors describe that sural nerve is formed by the union of medial sural cutaneous nerve with the peroneal communicating nerve [3–13]. Some other authors describe that sural nerve is formed by the union of medial sural cutaneous nerve with the lateral sural cutaneous nerve [14–17]. Because of these controversies the term sural nerve complex was coined by Ortiguela, which includes medial sural cutaneous nerve, lateral sural cutaneous nerve, peroneal communicating nerve, and sural nerve [6]. Medial sural cutaneous nerve originates from the tibial nerve in the popliteal fossa. It descends between the two heads of gastrocnemius muscle, deep to deep fascia covering the muscle. It becomes superficial by piercing the deep fascia at the junction of middle and distal thirds of the leg. The nerve lies usually medially sometimes laterally to the short saphenous vein. The nerve joins the peroneal communicating nerve to form sural nerve. When there is no communication between medial sural cutaneous nerve and peroneal
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